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Search Results: 1 - 10 of 228821 matches for " R. Wayne Wagner "
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Obstetric Hemorrhage and Hypothermia: Chilling Facts  [PDF]
Wayne R. Cohen
Open Journal of Obstetrics and Gynecology (OJOG) , 2018, DOI: 10.4236/ojog.2018.813128
Abstract: Objective: This clinical perspective reviews the causes, prevention and treatment of accidental hypothermia in severe obstetric hemorrhage. Results: Hypothermia commonly accompanies hemorrhagic shock. Hypothermia can inhibit blood coagulation, reduce cardiac contractility, predispose to arrhythmias, contribute to acidosis, and suppress immune function. Several techniques for warming a patient or reducing heat loss are available. Keeping the patient dry, covering her with blankets, and raising the ambient temperature in the room are valuable. Methods to transmit heat actively are more effective. Forced warm air blowers are efficient. Heating intravenous fluids is important, and warm fluid lavage of the open abdomen can be effective. Conclusion: Monitoring core temperature in the operating room and choosing therapy is a shared responsibility of surgeon and anesthesiologist.
Projected Evolution of California's San Francisco Bay-Delta-River System in a Century of Climate Change
James E. Cloern, Noah Knowles, Larry R. Brown, Daniel Cayan, Michael D. Dettinger, Tara L. Morgan, David H. Schoellhamer, Mark T. Stacey, Mick van der Wegen, R. Wayne Wagner, Alan D. Jassby
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0024465
Abstract: Background Accumulating evidence shows that the planet is warming as a response to human emissions of greenhouse gases. Strategies of adaptation to climate change will require quantitative projections of how altered regional patterns of temperature, precipitation and sea level could cascade to provoke local impacts such as modified water supplies, increasing risks of coastal flooding, and growing challenges to sustainability of native species. Methodology/Principal Findings We linked a series of models to investigate responses of California's San Francisco Estuary-Watershed (SFEW) system to two contrasting scenarios of climate change. Model outputs for scenarios of fast and moderate warming are presented as 2010–2099 projections of nine indicators of changing climate, hydrology and habitat quality. Trends of these indicators measure rates of: increasing air and water temperatures, salinity and sea level; decreasing precipitation, runoff, snowmelt contribution to runoff, and suspended sediment concentrations; and increasing frequency of extreme environmental conditions such as water temperatures and sea level beyond the ranges of historical observations. Conclusions/Significance Most of these environmental indicators change substantially over the 21st century, and many would present challenges to natural and managed systems. Adaptations to these changes will require flexible planning to cope with growing risks to humans and the challenges of meeting demands for fresh water and sustaining native biota. Programs of ecosystem rehabilitation and biodiversity conservation in coastal landscapes will be most likely to meet their objectives if they are designed from considerations that include: (1) an integrated perspective that river-estuary systems are influenced by effects of climate change operating on both watersheds and oceans; (2) varying sensitivity among environmental indicators to the uncertainty of future climates; (3) inevitability of biological community changes as responses to cumulative effects of climate change and other drivers of habitat transformations; and (4) anticipation and adaptation to the growing probability of ecosystem regime shifts.
Assessing Risks to Wildlife Populations from Multiple Stressors: Overview of the Problem and Research Needs.
Wayne R. Munns, Jr.
Ecology and Society , 2006,
Abstract: Wildlife populations are experiencing increasing pressure from human-induced changes in the landscape. Stressors including agricultural and urban land use, introduced invasive and exotic species, nutrient enrichment, direct human disturbance, and toxic chemicals directly or indirectly influence the quality and quantity of habitat used by terrestrial and aquatic wildlife. Governmental agencies such as the U.S. Environmental Protection Agency are required to assess risks to wildlife populations, in its broadest definition, that result from exposure to these stressors, yet considerable uncertainty exists with respect to how such assessments should be conducted. This uncertainty is compounded by questions concerning the interactive effects of co-occurring stressors, appropriate spatial scales of analysis, extrapolation of response data among species and from organisms to populations, and imperfect knowledge and use of limited data sets. Further, different risk problems require varying degrees of sophistication, methodological refinement, and data quality. These issues suggest a number of research needs to improve methods for wildlife risk assessments, including continued development of population dynamics models to evaluate the effects of multiple stressors at varying spatial scales, methods for extrapolating across endpoints and species with reasonable confidence, stressor-response relations and methods for combining them in predictive and diagnostic assessments, and accessible data sets describing the ecology of terrestrial and aquatic species. Case study application of models and methods for assessing wildlife risk will help to demonstrate their strengths and limitations for solving particular risk problems.
Topological Combinatorics of a Quantized String Gravitational Metric
Wayne R. Lundberg
Physics , 1997,
Abstract: A string-theoretic structure of the standard model is defined having a 4-D quantum gravity metric consistent with topological and algebraic first principles. Unique topological diagrams of string states, strong and weak interactions and quark families are evolved from this metric (but published separately). The theoretical structure includes known static and dynamic symmetries. A philosophical perspective on modern physics originates numerous opportunities for formal mathematical discussion.
A Cyclic Universe without Missing Mass: Implications of R->alpha'/R
Wayne R. Lundberg
Physics , 2000,
Abstract: Results from string theory conclude that a spatial dimension R is equivalent to *'/R. If R is considered as a four-space dimension, several interesting results emerge. In this paradigm, *'/R exists in a time-reversed, "anti- parallel" universe. Cosmological distances in our real-time universe are equivalent to the compact dimensions at the instant of a Big Bang in a time- inverted universe. This model agrees with standard black hole theory in that particles become frozen in time when they reach the 'singularity' (of dimension alpha'). A particle which enters a black hole in real time exits from the Big Bang or "white hole" in the time-inverted universe, leaving behind a trace of annihilation radiation. A diagram of this phenomenon is constructed, consistent with existing knowledge of the early universe. The primordeal black holes predicted by Hawking are required. A cyclic universe is described by M^2\p,n + T^2\n = 1. The "missing mass" proscribed by standard closed- universe theories is not required. This result is useful if experimental evidence in the search for dark matter continues to leave a significant "missing mass" - and particularly in light of more recent observations indicating that, in fact, inflation continues at a much reduced rate.
Understanding Beth, the Particulate Mass Functional
Wayne R. Lundberg
Physics , 2002,
Abstract: A geometric relationship between loop quantum gravity and partitioned (triangulated) string theory is discussed. Combinatorial analysis reveals that three spatial and three curvature dimensions, intrinsic to the partitioned string, are necessary to replicate Standard Model particles and interactions. This analysis has established that particulate mass is determined by a functional relationship involving these six extra dimensions. The combinatorial analysis involves non-commutative 3D-matrix algebra which forms the mathematical underpinnings of Dirac notation. The functional relationship (symbolized by Beth) requires exponential, Randall-Sundrum, scaling to compute mass. Through the proper interpretation of complex gravity a cyclic cosmological model is developed. This formulation of cyclic cosmology inherently involves observed dark energy. Thus, a comprehensive theory is constructed from geometric fundamentals which models both massive, oscillating neutrinos and the current epoch of mini-inflation.
Unique Premedical Education Experience in Public Health and Equity: Combined BA/MD Summer Practicum  [PDF]
Amy Clithero, Robert Sapien, Judith Kitzes, Summers Kalishman, Sharon Wayne, Brian Solan, Lana Wagner, Valerie Romero-Leggott
Creative Education (CE) , 2013, DOI: 10.4236/ce.2013.47A2021

Background: Physicians will need increased skills in the areas of public health, equity based interventions and patient safety skills to address the medical needs of patients in the 21st century. Premedical education and experiences is one strategy to address these areas. Methods: A one month rural summer practicum was developed for all BA/MD students. Key components include: 1) physician shadowing; 2) tutorials; 3) narrative writings; and 4) group community projects. Students attend a preparatory community service course prior to the practicum. Pre/post practicum surveys assessed students’ attitudes and skills with respect to community interventions. Post practicum surveys evaluate the elements of the practicum. Results: Survey results demonstrated no significant change in opinions or skills and activities with respect to community interventions. Highly rated items in the post practicum evaluations included physician shadowing, community activities, and opportunities to learn from others. Conclusions: A pre-medical practicum experience can help students define their roles as future physicians and increase their interactions within communities around public health issues. Whether this translates into improved involvement of physicians using public health equity based interventions is an area of ongoing study.

Perinatal consequences of disproportionate fetal trunk growth  [PDF]
Ralph L. Cavalieri, Suzanne Laroche, Wayne R. Cohen
Open Journal of Obstetrics and Gynecology (OJOG) , 2012, DOI: 10.4236/ojog.2012.22025
Abstract: Objective: To identify the impact of an abnormally large neonatal chest circumference relative to head circumference on labor and neonatal morbidity. Methods: We used a retrospective cohort design to study 54 obstetric cases in which the neonatal thoracic circumference was ≥2.5 cm greater than that of the head. For each case we sought controls with a smaller thorax-head circumference difference. Ninety-seven controls were matched with their respective cases for birth weight, parity, maternal body mass index (BMI), and maternal ethnicity. Results: Cases had significantly smaller heads and larger trunks than controls (P < 0.0001). Cases were twice as likely (39% vs 19%, P = 0.007) to require admission to the neonatal intensive care unit. There was no significant difference between cases and controls in the frequency of shoulder dystocia, long second stage, or long deceleration phase of labor. However, compound presentations occurred more frequently in the cases than in controls (5.5% vs 0%, P = 0.044). Conclusion: Babies with disproportionately large trunk growth were at risk for requiring neonatal intensive care and for compound presentation.
A Response to Some of the Points of: When Academic Disagreement Becomes Harassment and Persecution
Wayne Bishop,R. James Milgram
Nonpartisan Education Review , 2012,
Abstract: An error filled complaint was recently posted on the Stanford web-site of Professor of Mathematics Education Jo Boaler. It begins:“Honest academic debate lies at the core of good scholarship. But what happens when, under the guise of academic freedom, people distort the truth in order to promote their position and discredit someone’s evidence? I have suffered serious intellectual persecution for a number of years and decided it is now time to reveal the details.”The irony of this claim of violation of honest academic debate - absolutely essential to academia - is overwhelming. Herein are addressed some of the more obvious points.
Boltzmann's H-theorem, its limitations, and the birth of (fully) statistical mechanics
Harvey R. Brown,Wayne Myrvold
Physics , 2008,
Abstract: A comparison is made of the traditional Loschmidt (reversibility) and Zermelo (recurrence) objections to Boltzmann's H-theorem, and its simplified variant in the Ehrenfests' 1912 wind-tree model. The little-cited 1896 (pre-recurrence) objection of Zermelo (similar to an 1889 argument due to Poincare) is also analysed. Significant differences between the objections are highlighted, and several old and modern misconceptions concerning both them and the H-theorem are clarified. We give particular emphasis to the radical nature of Poincare's and Zermelo's attack, and the importance of the shift in Boltzmann's thinking in response to the objections as a whole.
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